Public Health Institute of Western Massachusetts Director of Programs and Development Sarita Hudson and Baystate Medical Center pediatrician Dr. Matthew Sadof speak about Springfield's asthma rates to the City Council's Health and Human Services Committee.

Nearly one in five of Springfield's children have asthma, and the disease sends city residents to emergency rooms at double the state-wide rate.

But funding for two programs that could help local patients breathe easier has dried up in recent years, health advocates told a City Council committee Thursday evening.

City Councilor Jesse Lederman organized the Health and Human Services Committee meeting after the Asthma and Allergy Foundation of America (AAFA) released a report that ranked Springfield the most challenging metropolitan area in the United States to live with asthma.

"This report that came out and the data that was just presented should be viewed as a call to action," said Dr. Matthew Sadof, a pediatrician at Baystate Medical Center and a member of the Pioneer Valley Asthma Coalition. "This is about health equity, this is about access, this is about lost wages, this is about poverty."

8 percent of people in the U.S. and 8.4 percent of children have asthma, with black people and Puerto Ricans more like to have the illness. Poverty is also correlated with the disease, according to the AAFA.

While Springfield had the tenth highest asthma rate of the cities surveyed, it had the highest rate of asthma-linked emergency room visits - a sign that cases in the city are less well controlled than in other parts of the country. Springfield's rate of hospitalizations is particularly notable, given that it was not in the top 15 for poverty rate, poor air quality or lack of health insurance - indicators which are linked to poor asthma health outcomes.

Springfield did have the seventh highest pollen count of the 100 ranked cities.

The AAFA noted that several of the highest ranked cities were located in what the organization termed the "Northeast Mid-Atlantic Asthma Belt" - a swath of coastal states from North Carolina to New England which had particularly high asthma rates.

"Poverty, air quality and access to specialists are key risk factors for these cities. This is likely a product of more industrial and urban populations," the report said. "Asthma rates tend to be higher, especially among children, in urban locations due to more rental housing, more manufacturing and industrial businesses, and proximity to high-traffic roadways."

At the meeting, Sadoff and Public Health Institute of Western Massachusetts Director of Programs and Development Sarita Hudson said health inequities are deeply pronounced in Springfield and across the state. Latinos are four times more likely and black people are two times more likely to visit the emergency room due to asthma, according to a presentation given by the group.

In Springfield, 30.3 percent of people living in households earning less that $25,000 per year have asthma -- nearly four times the rate for households earning between $25,000 and $75,000 per year. And those affected are often least able to bear the medical bills and lost wages caused by emergency room visits.

State, local and federal agencies have devoted resources to studying the problem and working on solutions. But two important initiatives have lost funding in recent years, Hudson and Sadof said.

The Reducing Ethnic/Racial Asthma Disparities in Youth study sent communty health workers on home visits to several hundred at-risk families to provide education on asthma treatment and suggest ways of reducing asthma triggers in the home. Preliminary results were promising, according to the CDC, with a 94 percent reduction in asthma hospitalizations, 46 percent reduction in emergency room visits, and a two-day reduction in asthma symptoms.

But state and federal funding for the study, which was designed to serve as a pilot for a possible widespread deployment of the program, dried up by 2015. And the home visits have not been scaled up in Western Massachusetts despite strong evidence of their effectiveness, Sadof said. Results from the study are currently being reviewed for publication.

And a program to boost asthma education by nurses in Springfield Public Schools -- which helped the district win an award from the American Lung Association -- also lost its funding.

"We were really proud at that point. But the funding went away," Hudson said.

Lederman and Councilor Timothy Allen said they would inquire with the city's Department of Health and Human Services about the status of the programs and advocate for solutions.

Lederman also said he would consider Sadof's request to declare asthma a public health emergency in Springfield.

"The numbers are startling and have been startling for a long time," Lederman said. "I think it really does represent an epidemic level."